Negative XMRV CFS study with Ila Singh's name on it (University of Utah)

The only progress they made was to show they couldn't find XMRV with their own assay.

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Can we say Dr. Singhs study showed that they couldnt find XMRV with their own assay?

Didnt they did detect mouse contaminant in 5% of their samples? Dr. Vernon quotes the study as saying: Using this assay, we found approximately 5 percent of our samples to be positive for products of the expected size, regardless of whether they were patients or healthy volunteers.

Am I misunderstanding something here?

Although the study failed to report this finding, Dr. Singh tells Mindy Kitei that they detected XMRV in their cultured positive controls as well. (All positive controls grew XMRV--as one would expect.) Mindy quotes the study: After weeks 2, 4, and 6, cultures were lysed and analyzed by Western blots...and by qPCR for XMRV.

Hi IVI, I am fairly sure the figure of 1.5% is way too high, more appropriate for a diagnosis of ideopathic chronic fatigue than ME or CFS. I am aware that even higher figures have been quoted using Reeves or Oxford criteria, but I don't trust either definition.
However, what I really disagree with, and its bugging me more and more, is this often quoted figure of 17 million world wide. Where is that coming from? If the prevalence data is right, and applies to all groups worldwide, then the real figure is much higher even with a prevalence of 0.4%. If it is actually 1.5%, even though I doubt it is, the real world population of ME/CFS patients is much much higher than 17 million. This is an old figure - it might have been true once, but that was a long time ago.
Bye,
Alex

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I agree, 1.5% seems way too high, there is just too much unfamiliarity with CFS in the general population for the number to be that high. Even 0.4% seems high to me but it might be right for the whole spectrum of CFS, based on more recent studies. That is about 1.2M CFS patients in the US, and if world population is going to reach 7B this year (which is what is predicted), then 0.4% is 28M CFS patients world-wide, not 17M. But where are all those patients?

My guess is that the majority of international CFS patients are mis-diagnosed or un-diagnosed. How many cases of AIDS in Africa are actually post-infection CFS due to their variety of local co-infections? AIDS is often diagnosed symptomatically in Africa, not always with testing...so probably the real world-wide CFS patient number is in the 20-40M patient range... but that is hard to prove, without competent international surveys.

I don't think anyone with a serious intent to see M.E/CFS as being of organic causation could contend that there has been any adequate epidemiological study of the condition, so yes all the figures are dubious - but if we do not accept those figures, what do we accept as being the epidemiology and demography of M.E/CFS ?

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When I first got sick with CFS I thought it was a rare disease, a few strange outbreaks, and not much information was available even though the illness had been diagnosed in patients for over 10 years (this was in the 90s). So it seemed there might be a few thousand cases in the US at that point. But since then CFS seems to have exploded, I personally have met many people with CFS in the course of ordinary working and living, even with my restricted activities. I suspect a new epidemiologic study would alarm even the denialists.

It's pretty harsh, but maybe not without cause. I don't think they are friends anymore

The Singh paper was yet another study where an apparently decent scientist proved beyond a shadow of a doubt that she couldn't find XMRV in anyone. Or at least that she couldn't find a VP62 plasmid clone in any CFS patients or controls. But since she did not use a human isolate as a positive control, her results are meaningless. She also proved again that a test derived from monkey antibodies to a VP62 clone doesn't detect anything in humans. What she didn't prove is that XMRV and other similar viruses are not infecting humans and she certainly didn't prove anything that doctors or patients should care about with respect to their treatment decisions. That she would presume to comment is outrageous.

Isint Dr. Deckoff Jones now working for the WPI? Is this then an unofficial response to the study from within the WPI? I could be totally wrong about this though!!!?

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It's her personal blog, so it shouldn't be seen as an (un)official response by the WPI. This has gotten her in trouble before though, as some people will see it as an (un)official response by the WPI. Ah well...

It's her personal blog, so it shouldn't be seen as an (un)official response by the WPI. This has gotten her in trouble before though, as some people will see it as an (un)official response by the WPI. Ah well...

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And indeed, it will be seen as such. Take this quote from another blog for example:

Yes, you have read it right: according to the WPI's clinical director, Singh is a backstabbing, corrupt scientist.

Dr. Deckoff-Jones has made it very clear that she does not speak for the WPI in any way. she posted this clearly on her blog.

This appears at the top of her blog page.

"In January 2011, I began to work for the WPI, but the content of this blog does not represent the institute. It is personal. Any opinions expressed are mine alone."

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Yeah, I know. However, she is clinical director at the WPI now and she is posting things that directly involve the WPI's research. So I can understand why some people have a hard time differentiating. Many companies would not allow this situation to exist.

I have only just caught up with this news over the weekend. Very disappointing, as there seemed to have been indications that this study might be positive.

The thing that sticks out to me is the suggestion that antibodies might be cross reactive to 'related antigens'. Is she referring here only to CFS patients in other studies, or also her own antibody tests reported in her patent document? She clearly stated in the patent document that she had found XMRV antibodies in CFS patients, but now in this published study she says not? So what was she picking up in her earlier antibody tests? Has she something more to tell us?

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hi Megan

I agree, it was disappointing for some.
You raise some good questions.

As for x reactivity......what is it that the antibodies might be reacting to? And how specific are the tests? Why the failure to find antibodies on this occasion?

I was also confused about the following statement....and I am not sure what to make of it:

The XMRV saga is far from over. Unlike Coffin and many other skeptics, Singh contends that a virus similar to XMRV does infect humans and her own work supports the prostate cancer connection

Is the suggestion here, that the strain found in prostrate cancer patients is different to that seen in CFS? Yet if this is indeed what is being suggested it does not make a lot of sense because Singhs clone for calibration purposes came from prostate tissue that I thought she said was for all intents and purposes the same as WPI samples because it was 99% the same. At least that is what thought I read. Maybe I am confused or have missed something.

Maybe someone can set me straight here?

If I am not mistaken, and that 1% difference is enough to support that statement above.....to distance XMRV in prostate cancer from that found in CFS, then how can she justify using a different strain as a means to calibrate findings in CFS patients?

Alternatively, is she alluding to another virus ie MLVs or something else?

When I first got sick with CFS I thought it was a rare disease, a few strange outbreaks, and not much information was available even though the illness had been diagnosed in patients for over 10 years (this was in the 90s). So it seemed there might be a few thousand cases in the US at that point. But since then CFS seems to have exploded, I personally have met many people with CFS in the course of ordinary working and living, even with my restricted activities. I suspect a new epidemiologic study would alarm even the denialists.

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The changes in diagnosed numbers, or in self describing numbers, have several possible explantions only one of which is increased prevalence. Even with increased prevalence, infectious causation need not be implied as social behavioural or even environmental changes can also impact upon prevalence for instance in the US it might be argued (Im not suggesting it is valid) that increased M.E/CFS diagnosis mirrors the increased obesity rate indicating either a direct connection (which I think was one of the implications of Reeves work ?) or some associated function of dietry change. The UK perspective certainly from 1987 was never really focussed on rarity or outbreak; heterogenaity and a National prevalence figure of 100,000 were the abiding descriptors, of course Royal Free Disease and Icelandic Flu were then still being used as co-names for M.E. M.E was only very rarely used at diagnosis PVFS/PVS etc being prefrerred by those specialists willing to give a physiological diagnosis - but by that stage it was clear that outbreaks alone werent able to explain the overall numbers. The increase from 100,000 to 250,00 as the agreed prevalence rate is pretty much unsubstantiated but as the 100,000 figure was never meaningfuly tested, the change is not of great significance.

That is not a secure report from which one can make useful deductions. Certainly Singh is saying that XMRV is definitively present in tissues associated with prostate tumours in some individuals, and that (with Shin el al) XMRV is defintively not present in the blood samples of people diagnosed with CFS, and that: "Given the lack of evidence for XMRV or XMRV-like viruses in our cohort of CFS patients, as well as the lack of these viruses in a set of patients previously tested positive, we feel that that XMRV is not associated with CFS".

Shin et al go on to say: " It is also vital to state that there is still a wealth of prior data (2, 10) to encourage further research into the involvement of other infectious agents in CFS, and these efforts must continue." the refs are to Devanur, L. D., and J. R. Kerr. 2006. Chronic fatigue syndrome. J Clin Virol 37:139- 50. and Komaroff, A. L., and D. S. Buchwald. 1998. Chronic fatigue syndrome: an update. Annu Rev Med 49:1-13. Whether Singh has other evidence to support a belief that there are XMRV like infectious agents involved in CFS, I don't think she has specified anywhere.

Shin et al go on to say: " It is also vital to state that there is still a wealth of prior data (2, 10) to encourage further research into the involvement of other infectious agents in CFS, and these efforts must continue." the refs are to Devanur, L. D., and J. R. Kerr. 2006. Chronic fatigue syndrome. J Clin Virol 37:139- 50. and Komaroff, A. L., and D. S. Buchwald. 1998. Chronic fatigue syndrome: an update. Annu Rev Med 49:1-13. Whether Singh has other evidence to support a belief that there are XMRV like infectious agents involved in CFS, I don't think she has specified anywhere.

IVI

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Yes, but i don't have too much trust that there would be real change, significantly more funding and more and better research. To me it seems more like a pc thing to say, a nice way to retreat from ME/CFS. I would not want to depend on them following up on this promise. It's the same thing the Wellcome Trust press release said.

I still believe the same thing, if you can't pay the reseach yourself or "force" them in one way or the other to give you more, they won't do it. They don't have money to give away and there are many other groups who want the same money and have strong lobbies and good support in the population.

That is not a secure report from which one can make useful deductions. Certainly Singh is saying that XMRV is definitively present in tissues associated with prostate tumours in some individuals, and that (with Shin el al) XMRV is defintively not present in the blood samples of people diagnosed with CFS, and that: "Given the lack of evidence for XMRV or XMRV-like viruses in our cohort of CFS patients, as well as the lack of these viruses in a set of patients previously tested positive, we feel that that XMRV is not associated with CFS".

Shin et al go on to say: " It is also vital to state that there is still a wealth of prior data (2, 10) to encourage further research into the involvement of other infectious agents in CFS, and these efforts must continue." the refs are to Devanur, L. D., and J. R. Kerr. 2006. Chronic fatigue syndrome. J Clin Virol 37:139- 50. and Komaroff, A. L., and D. S. Buchwald. 1998. Chronic fatigue syndrome: an update. Annu Rev Med 49:1-13. Whether Singh has other evidence to support a belief that there are XMRV like infectious agents involved in CFS, I don't think she has specified anywhere.

IVI

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Thanks for that. However my main interest was not the speculative last sentence of my post really.....it was all of what came before it. Can you or others comment on that?

There is a very interesting comment on Dr. Deckoff Jones' latest blog entry by the way. A person has gotten replies from Dr. Ila Singh and a reaction to that from Dr. Mikovits. It talks about samples from 25 patients that have been sent from the WPI to Dr. Singh and now vice versa again. The WPI is going to retest them.

[snip]I quoted both the reaction from Dr. Singh and Dr. Mikovits, but decided to cut it out of my message. I am not sure if those e-mails were meant to be published. The comment can still be read at Dr. Deckoff Joness blog though. It's Anonymous, May 9, 2011 8:47 AM

I think I can quote this part from Dr. Mikovits e-mail:

You understand a patient is not "contaminated" when we have isolated virus on multiple occasions ..these are not sequences but virions ..actual virus! That is NOT a contaminant. Of course, I understand your doubts why would anyone believe Frank and Sandy Ruscetti and the WPI over the rest of the world? Fair..but know there are others out there who are getting positive results in their patient populations and they have no doubt even with this latest study."

I was also confused about the following statement....and I am not sure what to make of it:

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Insearchof,

Yes the quote is confusing if it is correct, I guess its possible the journalist made a mistake, but given the other information it does seem cryptic. It would all be easier to let go of if these questions were answered. I hope Singh will answer some of these questions publicly, especially what she thinks her antibody tests referred to in her patent document were picking up.

"Tufts virologist Coffin said the research "looks like a very carefully done study" that is very close to replicating the original experiments, but with markedly different results.

He noted that the evidence for XMRV infection "rests on five legs," specifically the detection of:
Infected cells and integration junctions in vivo, which has only been shown in prostate cancer patients.
Viral antigens on cells from patients.
Antibodies against XMRV in samples from chronic fatigue syndrome patients.
Virus-like sequences, again in samples from chronic fatigue syndrome patients.
And isolation of infectious virus.

Of those, he said, all but the first have been challenged, "in the almost complete absence of credible confirmatory findings."

There is a very interesting comment on Dr. Deckoff Jones' latest blog entry by the way. A person has gotten replies from Dr. Ila Singh and a reaction to that from Dr. Mikovits. It talks about samples from 25 patients that have been sent from the WPI to Dr. Singh and now vice versa again. The WPI is going to retest them.

[snip]I quoted both the reaction from Dr. Singh and Dr. Mikovits, but decided to cut it out of my message. I am not sure if those e-mails were meant to be published. The comment can still be read at Dr. Deckoff Joness blog though. It's Anonymous, May 9, 2011 8:47 AM

I think I can quote this part from Dr. Mikovits e-mail:

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I just very much hope what Judy Mikovits said is correct and we will get to see those studies not too long from now. Let's see what we hear on 20/5. And of course even if there are more positive studies they could still be wrong. But it would be good news.

It's a shame Ila Singh did not add 25 samples of healthy controls to those she sends back. Everything coded and without cheating please

"Tufts virologist Coffin said the research "looks like a very carefully done study" that is very close to replicating the original experiments, but with markedly different results.

He noted that the evidence for XMRV infection "rests on five legs," specifically the detection of:
Infected cells and integration junctions in vivo, which has only been shown in prostate cancer patients.
Viral antigens on cells from patients.
Antibodies against XMRV in samples from chronic fatigue syndrome patients.
Virus-like sequences, again in samples from chronic fatigue syndrome patients.
And isolation of infectious virus.

Of those, he said, all but the first have been challenged, "in the almost complete absence of credible confirmatory findings."

Is it just a detail without much significance or does it mean something that Coffin now does not call the finding of XMRV integration in prostate cancer "challenged" anymore?
I think they challenged that too, by saying at least some integration sites are exactly the same as in a cell line and therefore at least those must be from contamination. Have they now changed their opinion on this?

Is it just a detail without much significance or does it mean something that Coffin now does not call the finding of XMRV integration in prostate cancer "challenged" anymore? I think they challenged that too, by saying at least some integration sites are exactly the same as in a cell line and therefore at least those must be from contamination. Have they now changed their opinion on this?

XMRV shares extensive sequence identity with known xenotropic, nonecotropic and polytropic murine viruses; the first of which is known to infect many common human tumour cell lines, a phenomenon that has confused retrovirologists looking for disease associations for over three decades. Most putative associations of new or old human retroviruses with diseases (including CFS and prostate cancer) have turned out to be laboratory artefacts [19]. The case of XMRV as a new human pathogen must be judged against this background [22]. It is true that we cannot formally rule out the possibility that the samples in question are infected with XMRV and simultaneously contaminated by mouse DNA, although this is unlikely since we found no IAP-negative samples from which we amplified MLV-specific sequences (data not shown). Also, the failure to detect XMRV sequences other than in association with mouse DNA contamination in our cohort does not mean that the virus is not present in other, unrelated, cohorts.

It is difficult to explain how the contamination may have occurred, especially since the samples came from three unrelated centres in the UK, Korea and Thailand. As both our negative tissue and PBS controls treated in parallel with the FFPE were XMRV PCR-negative, it is unlikely that contamination was introduced via reagents. The UK FFPE tissue samples were stored boxed and stacked in a cupboard in the histopathology department for several years; and it is possible that contamination happened during that time, although why only a few samples (4.8%) were XMRV positive and the remainder not is difficult to explain. Nor does it explain the Thai and Korean results on tissue collected prospectively for the study. It does, however, demonstrate the necessity of controlling by highly specific and sensitive means for mouse contamination.